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    the Medical Section, Resolution Team   
503-947-7816   

Worker requested medical examination


If the compensability of your claim has been denied by the insurer based on an insurer medical examination (IME), and your doctor (attending physician) disagrees with the IME results, you may be eligible to request a medical examination by a doctor chosen by the Workers’ Compensation Division. In order to be eligible for this exam, you must appeal the denied claim within 60 days of the denial date and request an exam by writing to the Workers' Compensation Division, Resolution Team, PO Box 14480, Salem, OR 97309. A copy of your request for the exam must be sent simultaneously to the insurer or self-insured employer. The request must include:

(a) The name, address, and claim identifying information of the injured worker;

(b) A list of physicians, including names and addresses, who have previously provided medical treatment to the worker on this claim or who have previously provided medical services to the worker related to the claimed condition(s);

(c) The date the worker requested a hearing and a copy of the hearing request;

(d) A copy of the insurer’s denial letter; and

(e) Document(s) that demonstrate that the attending physician did not concur with the Insurer Medical Examination report(s).

   

Worker requested medical examination guide
Worker requested medical examination checklist
Doctors participating in workers’ compensation exams

If you have questions about the information contained in this document, please contact the Medical Section, Resolution Team, 503-947-7816.

 

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